title: Biology of anterior cruciate ligament injury and repair: Kappa delta ann doner vaughn award paper 2013.
abstract: Anterior cruciate ligament (ACL) injuries are currently treated by removing the injured ligament and replacing it with a tendon graft. Recent studies have examined alternative treatment methods, including repair and regeneration of the injured ligament. In order to make such an approach feasible, a basic understanding of ACL biology and its response to injury is needed. Identification of obstacles to native ACL healing can then be identified and potentially resolved using tissue engineering strategies-first, with in vitro screening assays, and then with in vivo models of efficacy and safety. This Perspectives paper outlines this path of discovery for optimizing ACL healing using a bio-enhanced repair technique. This journey required constructing indices of the functional tissue response, pioneering physiologically based methods of biomechanical testing, developing, and validating clinically relevant animal models, and creating and optimizing translationally feasible scaffolds, surgical techniques, and biologic additives. Using this systematic translational approach, "bio-enhanced" ACL repair has been advanced to the point where it may become an option for future treatment of acute ACL injuries and the prevention of subsequent post-traumatic osteoarthritis associated with this injury.
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, 02115, Massachusetts, USA. martha.murray@childrens.harvard.edu
authors.forename: Martha Meaney
authors.initials: MM
authors.lastname: Murray
authors.forename: Braden C
authors.initials: BC
authors.lastname: Fleming
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000502:physiology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001363:Awards and Prizes; D004195:Disease Models, Animal; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D007719:Knee Joint / Q000502:physiology / Q000601:surgery; D019637:Orthopedic Procedures; D010003:Osteoarthritis / Q000517:prevention & control; D019651:Plastic Surgery Procedures; D012038:Regeneration; D013718:Tensile Strength; D054457:Tissue Scaffolds; D016474:Weight-Bearing
keywords: anterior cruciate ligament; in vivo; osteoarthritis; reconstruction; repair